Current jobs related to Population Health Care Manager- AMH+ - Durham NC United States - Duke Health
-
Population Health Resource Associate- AMH+
3 weeks ago
Durham, United States Duke Health Full timeDuke Connected Care, a community-based, physician-led network, includes a group of doctors, hospitals and other healthcare providers who work together to deliver high-quality care to Medicare Fee-for-Service patients in Durham and itssurrounding areas.General Description of the Job ClassThe Population Health Resource Associate will implement, plan and...
-
Population Health Specialist
3 weeks ago
Durham, North Carolina, United States Duke Health Full timeAbout the RoleDuke Health is seeking a highly skilled Population Health Specialist to join our team. As a key member of our interdisciplinary team, you will be responsible for providing clinical expertise to specific complex and/or rising risk patient populations.Key ResponsibilitiesCoordinate and facilitate timely implementation of assessments, care plans,...
-
Population Health Care Manager
5 days ago
Durham, North Carolina, United States Duke Health Full timeJob Title: Population Health Care ManagerJob Summary:The Population Health Care Manager is a critical role in our organization, responsible for delivering clinical expertise to manage the healthcare needs of specific patient populations. This position functions as an integral part of an interdisciplinary team, working to optimize clinical outcomes through...
-
Care Manager
3 weeks ago
Durham, North Carolina, United States Duke Health Full timeAbout the RoleWe are seeking a highly skilled and dedicated Population Health Care Manager to join our team at Duke Health. As a key member of our healthcare team, you will play a vital role in delivering high-quality patient care and improving health outcomes for our patients.Key ResponsibilitiesDevelop and Implement Care Plans: Create and implement...
-
Nurse Practitioner/Physician Assistant
4 weeks ago
Asheville, NC, United States Appalachian Mountain Health Full timeDescription: *Physician Assistants/Nurse Practitioners-are you ready for a change? Don't miss this terrific opportunity to work with an underserved patient population in one of the most beautiful communities in the United States.**Appalachian Mountain Health (AMH)*, a Federally Qualified Health Center network based in Asheville, NC, is hiring a Physician...
-
Durham, North Carolina, United States Duke Health Full timeJob SummaryWe are seeking a highly skilled Population Health Care Manager to join our team at Lincoln Community Health Center. As a key member of our care management team, you will be responsible for delivering clinical expertise to manage the health care needs of specific patient populations across the continuum of care.Key ResponsibilitiesDevelop and...
-
Durham, United States Duke Health Full timePopulation Health Care Manager-Embedded at Lincoln Community Health Center Work Arrangement: Requisition Number: 239892 Regular or Temporary: Regular Location: Durham, NC, US, 27710 Personnel Area: DIN/Connected Care Date: Jul 9, 2024 At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones,...
-
Physician Assistant
4 weeks ago
Robbinsville, NC, United States Appalachian Mountain Health Full time*Experienced Physician Assistants/Nurse Practitioners--are you ready for a change? Don't miss this terrific opportunity to work with an underserved patient population in this beautiful, picturesque community!**Appalachian Mountain Health ("AMH")*, a Federally Qualified Health Center network based in Asheville, NC, is hiring an experienced Physician Assistant...
-
Family Health Navigator
3 weeks ago
Durham, North Carolina, United States Duke Health Full timeAbout the RoleWe are seeking a highly motivated and experienced Population Health Resource Associate to join our team at Duke Health. As a key member of our pediatric population health team, you will play a critical role in supporting the health and well-being of our patients and their families.Key ResponsibilitiesProvide outreach and care management support...
-
Population Health Management Director
1 week ago
San Antonio, TX, United States University Health Full timePOSITION SUMMARY/RESPONSIBILITIES Provide oversight and management of the Community First Health Plans, Inc. (Community First) clinical activities and deliverables related to utilization management (UM), service coordination (SC), and behavioral health (BH) assuring all contractual, regulatory, and accreditation standards are met. Provide administrative and...
-
Vice President Population Health Management
1 week ago
San Antonio, TX, United States University Health Full timePOSITION SUMMARY/RESPONSIBILITIES Promotes a population health management approach to health care within a managed health care environment for assigned product lines including STAR Kids, STAR+PLUS, Medicare Advantage and Medicare Advantage Dual Special Needs Plan (D-SNP). Supports Community First's goals to prevent illness, injury, disability and early...
-
Population Health Management Manager(RN)
7 days ago
San Antonio, TX, United States University Health Full timePOSITION SUMMARY/RESPONSIBILITIES Manages, supervises Service Coordinators, and assists the Director of STAR Kids with oversight of Service Coordination (SC) staff in the Population Health Management department to facilitate high-quality, cost-effective care for Community First Health Plans, Inc. (Community First) STAR Kids Members. Works with Community...
-
Population Health Resource Associate
3 weeks ago
Durham, North Carolina, United States Duke Health Full timeAbout the RoleWe are seeking a highly motivated and experienced Population Health Resource Associate to join our team at Duke Health. As a key member of our pediatric population health team, you will play a critical role in supporting the health and well-being of our patients and their families.Key ResponsibilitiesProvide outreach and care management support...
-
Durham, United States Duke Health Full timePopulation Health Resource Associate- Pediatric Family Advocate Work Arrangement: Requisition Number: 234887 Regular or Temporary: Regular Location: Durham, NC, US, 27710 Personnel Area: DIN/Connected Care Date: Jun 25, 2024 At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the...
-
Population Health Resource Associate
2 weeks ago
Durham, North Carolina, United States Duke Health Full timeJob SummaryWe are seeking a highly motivated and compassionate Population Health Resource Associate - Pediatric Family Advocate to join our team at Duke Health. This role will work closely with our care managers and specialists to provide support and advocacy to patients and their families navigating intellectual and developmental disabilities (I/DD)...
-
Ambulatory Care Nurse II
1 month ago
Raleigh, NC, United States WakeMed Full timeAbout WakeMed: Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care. For more information, visit www.wakemed.org. EOE Position Information: The Ambulatory...
-
Ambulatory Care Nurse II
5 days ago
Garner, NC, United States WakeMed Full timeAbout WakeMed: Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care. For more information, visit www.wakemed.org. EOE Position Information: The Ambulatory...
-
Ambulatory Care Nurse II
3 months ago
Raleigh, NC, United States WakeMed Full timeAbout WakeMed:Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care. For more information, visit www.wakemed.org.EOEPosition Information:The Ambulatory Care...
-
Ambulatory Care Nurse II
1 week ago
Raleigh, NC, United States WakeMed Full timeAbout WakeMed:Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care. For more information, visit www.wakemed.org.EOEPosition Information:The Ambulatory Care...
-
Durham, North Carolina, United States Duke Health Full timeJob Summary The Population Health Resource Associate Pediatric Family Advocate will work with our care managers and specialists as a resource to help our patients and their families navigate new or existing IDD diagnosis by providing overall support and being an advocate. Key Responsibilities Provide outreach and care management support to patients Educate...
Population Health Care Manager- AMH+
3 months ago
At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.
External Candidates eligible for a $10,000.00 Commitment Bonus paid over 2 years
Occ Summary
The Population Health Care Manager is responsible for clinical expertise for specific complex and/or rising risk patient populations with a design to meet specific contractual and program related requirements. This role will perform disease management, assessment of disease, care plan development and facilitation, referral to appropriate levels of care, etc. The role functions as an integral part of an interdisciplinary team, ensuring excellence with transitions of care to achieve optimal clinical outcomes through a seamless model of access and care. Focus on improving the health status and care for individuals with chronic conditions with complex medical, mental health and psychosocial issues.
Tailored Plan Care Management
The Behavioral Health and Intellectual/Developmental Disability (I/DD) Tailored Care Management (Tailored CM) model reflects the goal of whole-person care management in NC Medicaid Managed Care. Provider-based care management promotes integrated care and offers beneficiaries choice in how they receive care management.
Through Tailored CM, Behavioral Health I/DD Tailored Plan beneficiaries will have a single designated care manager supported by a multidisciplinary care team to provide whole-person care management that addresses all of their needs, spanning: physical health, behavioral health, I/DD, traumatic brain injuries (TBI), pharmacy, long-term services and supports (LTSS) and unmet health-related resource needs. Effective, integrated and well-coordinated care management depends on care team members having the ability to efficiently exchange member health information and use that information to monitor and respond to medical and nonmedical issues that could impact beneficiaries.
Effective December 1, 2023 DukeWell will be providing Tailored Care Management services to eligible members attributed to the following AMH+ certified Duke practices:
Duke Children’s Primary Care North Duke Street
Duke Children’s Primary Care South Durham
Duke Children’s Primary Care Briar Creek
Duke Internal Med./Peds North Duke Street
Durham Family Medicine
Durham Pediatric Clinic
Duke Outpatient Clinic
Work Performed
- Coordinate and facilitate timely implementation of assessments, care plans, and appropriate interventions for identified patient population to determine patient health, social situation, physical environment, mental health, substance use, expressed trauma, economic status, and education to patients while exercising discretion and independent judgment; following established policies and procedures.
- Provide individual treatment to address barriers and identified concerns by accessing systematically identified data from multiple sources such as patient medical records, claims, and program metric reports to target recipient(s) and provider(s) for outreach, education, and intervention.
- Perform targeted interventions to assist patients with connection to primary care providers and other health care resources. Involve the patient and their support systems (i.e. caregiver, family, etc.) in the decision-making process.
- Use a patient-centric, collaborative partnership approach to assist the patient with improved self-management and identifying barriers by addressing the total individual, inclusive of medical, psychosocial, behavioral, and spiritual needs.
- Utilize proven processes to measure a patients understanding and acceptance of the proposed plan(s), his/her willingness to change, and his/her support to maintain health behavior change.
- Apply teaching and learning theories to assist patients and families with physical and emotional impact of body changes and chronic illness.
- Monitor quality and effectiveness of interventions to the population by setting long term and/or short-term specific, measurable goal(s).
- Electronically document all activity in Maestro, and other documentation systems relevant t o the position.
- Communicate and coordinate with all provider(s) and member(s) of the care team as needed to minimize fragmented care and foster appropriate utilization of services. This will include, navigating transitions of care generally from hospital to home or community facilities.
- Facilitate interdisciplinary communication to include specialists, PCP, RN, psychiatrist and other key providers.
- Interface with key providers (e.g. discharge planners, social workers, physicians, psychiatrist etc.) within the hospital, primary care practices, public health and social service departments, as well as mental health agencies and other community resources to assure that patients are linked to and engaged in services.
- Provide on-site, community, and telephonic outreach to patients, providers, and community stakeholders assisting with identification of treatment history, diagnoses and patient care components both internally and externally to ensure that services provided are sensitive to the needs of individual patients and take into account ethnic and cultural backgrounds.
- This position may require home visits based on business rules and clinical need of identified patient population.
- Provide feedback to TL, management, and executive leadership that will enhance negotiations with payers, improve care management, and/or address gaps in care.
- Develop and maintain positive relationships with customers internal and external to Duke Health System.
Minimum Qualifications
Education
Bachelor's degree in a clinical field such as Nursing, Counseling, Social Work, Therapy, Allied Health, or community health related fields.
Experience
3 years of clinical experience required.
Degrees, Licensures, Certifications
Must have a current license in at least one of these areas:
Current or compact RN licensure in the state of North Carolina
Current licensure as a licensed clinical social worker by the NC Social Work Certification and Licensure Board
Current licensure as a Licensed Professional Counselor by the state of NC,
Current licensure as a Licensed Addiction Specialist by the state of North Carolina.
Requires ACM or CCM certification within 3 years of hire date.
POPULATION HEALTH CARE MANAGER
Job Level: G1
Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the communityfeel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
